Did marketing outpace the science?

Key Points:

• Boston Scientific has heavily promoted the Watchman heart implant, designed to reduce stroke risk in atrial fibrillation (A-fib) patients by sealing off the heart area where clots form, as an alternative to lifelong blood thinners; sales reached nearly $2 billion in 2025 with over 800,000 devices implanted worldwide.
• Despite marketing success, recent clinical trials and expert opinions have raised concerns about the Watchman’s effectiveness and safety compared to blood thinners, with some studies showing it may be no better or even worse, leading to debates over possible overuse and "indication creep" beyond FDA-approved patient groups.
• The company has invested millions in doctor consulting fees and direct-to-patient advertising campaigns, including national TV ads, which is unusual for high-risk surgical devices, fueling patient demand and raising ethical questions about promoting an invasive procedure with borderline evidence.
• The FDA initially approved the Watchman with restrictions for patients at high stroke risk who have a valid reason not to take blood thinners, but critics argue the device is increasingly used beyond these guidelines, sometimes without strong medical justification, as seen in high implant rates at certain hospitals.
• Boston Scientific faces challenges after mixed results from recent studies and slowing sales growth; the company plans to intensify education and marketing efforts to counter skepticism, emphasizing patient choice and the device as a proven alternative, while some cardiologists urge caution given the procedure’s risks and uncertain benefits.